Thick Twice Before You Fix

  • Dominic Puthoor Orthopedic Oncologist and Professor, Amala Institute of Medical Sciences


An 18-year old male presented with swelling of his leg with the mild tenderness of the tibia. X-ray showed a lytic lesion in the tibia (Figure 1(a)). The surgeon performed an open biopsy along with curettage and bone grafting. During curettage, he noticed a break in the cortex and therefore went on to do an interlock- ing nailing also (Figure 1(b)). The biopsy was suggestive of an Adamantinoma. It recurred within 3 months (Figure 1(c)). The nail caused a tumour to spread extensively. It also precluded an MRI scan to consider possible limb salvage. In spite of an above-knee amputation, he developed pulmonary metastasis and died. If the surgeon had given a plaster instead, such a catastrophe would have been avoided.

How to Cite
PUTHOOR, Dominic. Thick Twice Before You Fix. Kerala Journal of Orthopaedics, [S.l.], v. 30, n. 1-2, p. 64–67, jan. 2018. Available at: <>. Date accessed: 16 oct. 2019.